1. Psychoneuroimmunology
Class 9
Stress II, Continued
and
Psychoneuroimmunology

2. Quiz 1 on Thursday
Quiz covers Class 1 up to and including first half of today’s class (i.e., remainder of Stress).
15 Questions, Multiple Choice
2 Extra Credit Questions: No penalty in getting them wrong!
20 minutes to complete quiz. Start of class.
Counts for 10% of course grade
Suggestions:
1. Download and study PowerPoints
2. Read the readings: PowerPoint + Readings  success
3. Self-quiz: Read a slide, page of text, cover it, then
ask yourself key points.
4. Review class notes: PowerPoint + Readings + Notes

3. Example Question
Pennebaker’s research on symptoms showed that people reported MORE SYMPTOMS when they:
___ A. Ran around an oval track
___ B. Ran around a cross-country track
___ C. Ran on a treadmill while hearing their own breathing
___ D. Ran on a treadmill while hearing street sounds
___ E. None of the above X

4. After-effects of Stress
Effects of stress can persist long after stressful event.
Aftereffects can be more devastating than the stressful event itself.
Stress depresses post-stress task performance (Glass & Singer, 1972)
Stress and social behavior. Where’s my contact lens? Please help! (Cohen & Spacapan, 1978)
a. Helping: Unavoidable stress ___ increases helping.
___ decreases helping X
Stress as an “overzealous teacher.” Social rejection
Failed relationship
Job loss

5. Learned Helplessness and Surrender Martin Seligman, 1970s
Normal rats last?
“Helpless” Rats last?
60 hrs.
30 min.

6. Dimensions of Stressful Events
Negative events
Uncontrollable events
Ambiguous events
Overload
Challenges to central domains of life
Who does better, regarding stress?
___ Person with one core purpose
___ Person with several core purposes X

7. How is stress be measured?
Measuring Stress
How is stress be measured?
Class completes Stress Measures

8. Stress Over the Past Year (A Home Grown Scale for This Class)
Over the past 12 months, how much stress did you experience, overall?
___ 1. None or almost none
___ Far less than usual
___ 3. Somewhat less than usual
___ 4. Same as usual
___ 5. More than usual
___ 6. Far more than usual
___ 7. An extreme amount
Problems with this measure?

9. Definitions of “House”
House as object
House as place
2400 sq feet,
large back lot,
aged heating and plumbing
Colonial style
Where grandparents settled after WW II Where mom and Uncle Joe were born
Where we had 4th of July every year
Where Suzy learned to drive.
Definitions of “Stress”
Stress as Event
Stress as Experience
Number of tasks due
Clarity re. stressors
Degree of control
Consequences of failure
How confident I feel.
How overwhelmed I feel
Point: How a thing is defined affects how it is understood. Defining stress in terms of events (Holmes & Rahe) vs. in terms of how people feel about events (Cohen, et al).

10. Social Readjustment Scale Holmes & Rahe, 1967
In the past year, have you experienced:
1. __ Death of a spouse/partner __ Wife starting/ending work 26
2. __ Divorce __ Change in personal habits 24
3. __ Marital separation __ Change in residence 20
7. __ Marriage __ Change to a new school 20
8. __ Being fired __ Change in church activities 19
17.__ Death of a close friend __ Change in social activities 18
18.__ Changing to different work __ Change in sleeping habits 16
19.__ Change in # spouse arguments __ Vacation 13
20.__ Taking a loan on house __ Minor law issue (ticket, etc.) 11

11. Social Readjustment Scale Predictive Power
Score of 150  50% chance of illness
Score of 300+  90% chance of:
Illness
Accident
“Blowing up”

12. SOCIAL READJUSTMENT RATING SCALE
CRITIQUE OF
SOCIAL READJUSTMENT RATING SCALE
(Holmes & Rahe, 1967)
1. Vague terms: “Change in personal habits”
2. Numeric values: Marriage = 50, Being fired = 47. What’s the 3 pt diff?
3. Relevance across populations: Vacation, being fired.
4. Doesn’t distinguish between pos and neg events
5. Doesn't consider how well event was resolved: Complaint prone pers.
6. Individual differences in propensity to mark events
7. Memory lapses

13. SUBJECTIVE STRESS MEASURE
Cohen, Kamarck, & Mermelstein, (1983)
For each question, choose from the following alternatives:
0 Never
1 Almost never
2 Sometimes
3 Fairly often
4 Very often
1. In the past month, how often have you been upset because of something that happened unexpectedly?
2. In the last month, how often have you felt nervous and “stressed”?
3. In the last month, how often have you found that you could not cope with all the things that you had to do?
4. In the last month, how often have you been angered because of things that were out of your control?
Note: Not the # times things out of control, but instead how angered you got when things got out of control. Why does this matter?

14. Hassles

15. The Measurement of Hassles Kanner, et al. 1981
Severity
1. somewhat severe
2. moderately severe
3. extremely severe
1. Misplacing or losing things. 1 2 3
2. Troublesome neighbors.
3. Social obligations.
4. Inconsiderate smokers.
5. Thoughts about death.
6. Health of a family member.

16. “Unspoken” Danger of Hassles?
Joey, did Gramps tell you about the Great Flood of 1954?
Joey, did Gramps tell you about the day the cable guy never came?
Disclosing major events is a health benefit—but normal “hassles” often don’t merit disclosing.

17. Workplace Stress
Workplace stress is most common, most preventable, chronic stressor
What are elements of workplace stress?
Overload: perception more important than total hours.
Time pressure: Time pressed 3X more likely to die early
Role conflict /ambiguity: Japanese baseball interpreters
Social isolation: Higher catecholamines, higher BP
Lack of control: Person/environment fit. Leads to coronary heart disease

18. Psychoneuroimmunology
Class 9
Psychoneuroimmunology

19. Psychoneuroimmunology
The relationship between psychological processes and the activities of the nervous, endocrine, and immune systems.

20. Immune System Review
Primary function: Distinguish self from non-self, attack foreign elements.
Main components:
Humoral response – anti-bacterial, prevent viral re-infection
Cell-mediated response – T cells (Tc cells) from Thymus gland, Tc respond to specific antigens, produce anti-antigen toxins.
Other blood components
Mitogen Test: Introducing chemical that stimulates cell production. Serves to test how “energetic” is immune system—e.g. how many white blood cells produced after mitogen introduced.
Mitogen benign version of Antigen, which is foreign substance that attacks body (e.g., bacteria, virus), causing antibody production.

21. Immunocompetence and Immunocompromise
Immunocompetence: How well immune system is working
Assessment:
a. Quantities of immune agents (T cells, white blood cells) b. Functioning of immune agents Activity Proliferation Transformation Cytotoxicity: Potency of, e.g. Tc cells’, antibody toxins
Immunocompromise: When immune system is impaired
Key Point: Stress can lead to immunocompromise

22. Stress and Immune Functioning
Stress and immunocompetence shown in:
Animal studies: Stressed rats display immune dysfunction
Observations: TB white blood cells less robust after stress
Accumulated Research: 38 studies show more stress  immunocompromise
The bigger the stressor, the worse the compromise.
Chopin
Hurricane Andrew (1992), NK cell cytotoxicity decreases. Tied to lack of sleep.
NOTE: This outcome fits which with measure ____Holmes & Rahe ___ Cohen et al. X

23. Chronic Stress and Acute Stress
On-going illness
Natural disaster
Family responsibilities
Major family conflict
Workload
Auto accident
Environmental noise
Job loss
Financial worries
Loss of loved one
Immunocompetence
STRESSOR
Days Exposed to Stressor

24. Stress-Induced Immunocompromise and Illness
Stress  Immunocompromise  colds, flu, herpes flare-ups
Daily hassles  reduced NK cell activity
Anticipatory stress  less robust TH cells. Mt. St. Helens/Pennebaker
School stress: 5 yr olds show increased cortisol, immunocompromise, upon starting kindergarten. Esp. if earthquake co-occurs!

25. Social Relations, Stress, and Illness
Personal relationships are key moderators of stress/illness connection.
(More on this when we discuss Social Support)
Rat pups separated from mothers show immunocompromise
Social Conditions linked to illness?
Bereavement (but mainly if linked to depression)
Loneliness
Marital separation

26. Spitz Foundling Home Studies
René Spitz
Orphaned babies, in foundling homes, all material needs met
Do not have an emotional care-giver
Tragically high levels of grief
Highly susceptible to disease
High mortality rate

27. DEPRIVATION DWARFISM

28. Social Connections as a Health Risk
Newlyweds Study
90 newlywed couples, discuss marital problems
Style of discussion coded as: a. Negative/hostile b. Positive/collaborative
Assessed immune functioning after discussions.
Which group shows immunocompromise?
____ Neg/hostile ___ Pos/collaborative X
Caregivers of chronically ill
Produce fewer immune agents, wounds heal slowly, weaker reaction to flu vaccine. Why?

29. Relation Between Stress and Health Not Perfect